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ERCP within 6 or 12 h for acute cholangitis: a propensity score-matched analysis
- Source :
- Surgical Endoscopy. 36:2418-2429
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- The optimal timing of biliary drainage by endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis remains controversial. The aim of our study was to determine if ERCP performed within 6 or 12 h of presentation was associated with improved clinical outcomes. Medical records for all patients with acute cholangitis who underwent ERCP at our institution between 2009 and 2018 were reviewed. Outcomes were compared between those who underwent ERCP within or after 12 h using propensity score framework. Our primary outcome was length of hospitalization. Secondary outcomes included in-hospital mortality, adverse events, ERCP failure, length of ICU stay, organ failure, recurrent cholangitis, and 30-day readmission. In secondary analysis, outcomes for ERCP done within or after 6 h were also compared. During study period, 487 patients with cholangitis were identified, of whom 147 had ERCP within 12 h of presentation. Using propensity score matching, we selected 145 pairs of patients with similar characteristics. Length of hospitalization was similar between ERCP within or after 12 h (135.9 vs 122.1 h, p 0.094). No difference was noted in mortality, ERCP failure, adverse events, need and length of ICU stay, and recurrent cholangitis. However, 30-day readmission rates were lower when ERCP within 12 h (7.6 vs 15.2, p 0.042). No significant difference was noted in aforementioned outcomes between ERCP performed within or after 6 h. ERCP performed within 6 h or 12 h of presentation was not associated with superior clinical outcomes, however, may result in reduced re-hospitalization.
- Subjects :
- medicine.medical_specialty
Endoscopic retrograde cholangiopancreatography
medicine.diagnostic_test
business.industry
Medical record
Length of hospitalization
Hepatology
digestive system
digestive system diseases
03 medical and health sciences
surgical procedures, operative
0302 clinical medicine
030220 oncology & carcinogenesis
Internal medicine
Propensity score matching
medicine
030211 gastroenterology & hepatology
Surgery
Recurrent cholangitis
Adverse effect
business
Abdominal surgery
Subjects
Details
- ISSN :
- 14322218 and 09302794
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Surgical Endoscopy
- Accession number :
- edsair.doi...........8fad691c423171b2ae1ea96cf05d3b7f